[Troponin elevation--differential diagnostic considerations and prognostic importance].

It has become increasingly evident that elevation of troponins can be demonstrated in other diseases than acute myocardial infarction. In this review we wanted to assess the prevalence and the clinical importance of troponin elevations in patients with mainly extra-cardiac organ manifestations. Only in chronic renal failure there appears to be evidence to support the conclusion that high levels of troponins are associated with an adverse clinical outcome. The mechanisms underlying the rise in troponins in non-cardiac diseases origin are unknown. One explanation could be that the patients involved have ischemic heart disease as co-morbidity. Severe stress caused by an acute non-cardiac clinical event may result in a minor leakage of myocardial markers. It is essential to perform a careful clinical evaluation in the case of patients with unexpected high levels of cardiac troponins.